In the fall of 2011, Commissioner Mayhew released a memo which announced the intention of the Department of Health and Human Services and Office of MaineCare Services to pursue a Value-Based Purchasing (VBP) strategy in order to improve the quality and cost of care for MaineCare members. The Department stated that they would strengthen the state’s collaboration with providers, leverage current programs, and take advantage of emerging federal opportunities. Three major initiatives were later unveiled under this VBP strategy; Health Homes, Behavioral Health Homes, and Accountable Communities. There are over 50,000 MaineCare members currently being served by these programs. More information for each program can be found on their individual pages.
The Department of Health and Human Services then demonstrated a commitment to improving the quality and cost of healthcare for all of Maine by applying for, and winning, a State Innovation Model (SIM) Testing grant from Centers for Medicare and Medicaid Services (CMS). In October of 2013, Maine received grant funds totaling $33 Million from CMS over the next three years to help Maine achieve the Triple Aim: Improving population health, improving patient experience, and lower the cost of care by 2016. This is an unprecedented partnership among physical and behavioral health providers, public and private insurers, data and system analysts, purchasers, workforce developers, and Maine consumers. The work being done under the SIM grant can be found on its webpage.
VBP Strategy Initatives:
- Health Homes Information for members with Chronic Conditions (Stage A)
- Behavioral Health Homes (Stage B)
- MaineCare Accountable Communities Initiative
- State Innovation Models Initiative
Stage A Health Home Year One Report:
The Department is pleased to release its "MaineCare Stage A Health Homes Year 1 Report: Implementation Findings and Baseline Analysis." The Department created and launched the first stage of its Health Homes initiative for members with chronic conditions in January 2013. Health Homes are a foundational component of the Department's Value-Based Purchasing Strategy and Maine's State Innovation Model (SIM) grant.
Building off the Maine multi-payer Patient Centered Medical Home model, the Department provides monthly reimbursement to primary care practices to support MaineCare members with chronic conditions through outreach, preventive health, care coordination, patient and family engagement. The Initiative also enables Community Care Teams across the state to partner with these Health Home practices to provide intensive care management and community supports to the highest need patients at the practices.
The Department commissioned the Muskie School of Public Service at the University of Southern Maine to produce this report.
Questions? Email James Leonard for questions about the project, upcoming events, and meetings.
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